Topical treatments for Seborrheic Keratosis: A systematic review

ABSTRACT

Background@#Seborrheic keratosis is a benign skin tumor removed through electrodessication, cryotherapy, or surgery. Alternative options may be beneficial to patients with contraindications to standard treatment, or those who prefer a non-invasive approach.@*Objectives@#To determine the effectiveness and safety of topical medications on seborrheic keratosis in the clearance of lesions, compared to placebo or standard therapy.@*Methods@#Studies involving seborrheic keratosis treated with any topical medication, compared to cryotherapy, electrodessication or placebo were obtained from MEDLINE, HERDIN, and Cochrane electronic databases from 1990 to June 2018.@*Results@#The search strategy yielded sixty articles. Nine publications (two randomized controlled trials, two non-randomized controlled trials, three cohort studies, two case reports) covering twelve medications (hydrogen peroxide, tacalcitol, calcipotriol, maxacalcitol, ammonium lactate, tazarotene, imiquimod, trichloroacetic acid, urea, nitric-zinc oxide, potassium dobesilate, 5-fluorouracil) were identified. The analysis showed that hydrogen peroxide 40% presented the highest level of evidence and was significantly more effective in the clearance of lesions compared to placebo.@*Conclusion@#Most of the treatments reviewed resulted in good to excellent lesion clearance, with a few well-tolerated minor adverse events. Topical therapy is a viable option; however, the level of evidence is low. Standard invasive therapy remains to be the more acceptable modality.